Healthcare Provider Details

I. General information

NPI: 1053231324
Provider Name (Legal Business Name): EXTENDED TOUCH HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 HARVEST DR
VERONA PA
15147-1711
US

IV. Provider business mailing address

197 HARVEST DR
VERONA PA
15147-1711
US

V. Phone/Fax

Practice location:
  • Phone: 412-403-5569
  • Fax:
Mailing address:
  • Phone: 412-403-5569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL PAYNE RUSSELL
Title or Position: OWNER
Credential:
Phone: 412-403-5569